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Essential Insights

Perspectives on essential people, communities, and hospitals

Finance and Payment Policy: 3 Key Insights from VITAL2018

Kimberly Green

Sep 12, 2018 || (0) comments

Several presentations at VITAL2018, our annual meeting, focused on a foundational issue for essential hospitals—finance and payment policy—and provided member insights on topics such as Section 1115 Medicaid waivers, state policy trends in the 340B Drug Pricing Program, and digitizing the revenue cycle.

1. Learn from other essential hospitals to better understand the policy landscape in your state.

Barbara Eyman, JD, Washington counsel to America’s Essential Hospitals, discussed recently approved Medicaid waivers and trends expected in coming years. Leaders from essential hospitals in Utah and Ohio provided on-the-ground examples detailing the status of Medicaid waiver proposals in their states and their potential effect on essential hospitals. In another presentation, Sarah Hesketh, vice president of external affairs at the California Association of Public Hospitals and Health Systems, discussed trends in 340B policy at the state level and how these policies might impact other states. Both presentations highlighted the benefit of essential hospitals learning from one another to apply lessons learned and to prepare for the future.

2. Pay attention to public charge because of the potential impact on the populations we serve.

The Trump administration is considering redefining “public charge”—a person who depends on federally funded services. Shahid Zaman, Esq., senior policy analyst at America’s Essential Hospitals, presented the history of public charge determination and the effect rumored changes could have on health and health care, especially for legal immigrants. This discussion was particularly relevant to essential hospitals, as the changes could reduce Medicaid enrollment and raise uncompensated care costs.

3. Hospitals can use the same type of digital transformation occurring in the private sector to improve patient experience.

Ranjit Pisharoty, chief operating and delivery officer at Sutherland Healthcare, and Nio Queiro, vice president of revenue cycle at association member Hennepin Healthcare, in Minneapolis, shared how essential hospitals can use the revenue cycle to drive a paradigm shift in health care and see each patient as a whole person first. Successful design comes from seeing the full patient journey through their eyes to create a 360-degree overview. It’s important for organizations not only to focus on their return on investment, but also on meeting customer needs. The presentation also highlighted the importance of adopting best practices and starting small. You only get one chance, so don’t launch an innovative change until it’s proven to work well. For more on digitizing the revenue cycle, read Sutherland Healthcare’s blog post.